Surgical instrument.



F. R. MUELLER & L. REHTHALBR.

SURGICAL INSTRUMENT.

APPLIOATION FILED SEPT. 29, 1910.

Patentd Sgpt. 5, 1911.

FREDERICK R. MUELLER AND LOUIS REHTHALER, OF CHICAGO, ILLINOIS.

SURGICAL IN STBUMENT.

Specification of Letters Patent.

Patented Sept. 5, 1911.

Application filed September 29, 1910. Serial No. 584,428.

To all whomii may concern:

Be it known that we, FREDERICK R. MUELLER and LOUIS REHTHALER, citizensof the United States of America, and residents of Chicago, county ofCook, State of Illinois, have invented certain new and usefulImprovements in Surgical Instruments, of which the following is aspecification.

The main objects of this invention are to provide an improved form ofsurgical instrument particularly adapted for such operations as theremoving of tonsils, adenoid tissue and other growths from the passageconnecting the nose and throat; to provide an instrument of this kindwith means operated simultaneously with the cutting member for grippingthe growth; to provide in an instrument of this kind means for causingthe relative movement of the operating parts independent of the movementof the handles; and to provide an improved construction wherebyoperating parts may be interchangeably attached to the handles.

An illustrative embodiment of this invention is shown in theaccompanying drawings, in which Figure 1 is a perspective view of asurgical instrument constructed according to this invention. Fig. 2 is alongitudinal sectional detail of the operating parts. Fig. 3 is anenlarged end view of the operating parts. Fig. 4 is a detail view,showing the method of securing the arms which carry the gripping jaws.Fig. 5 is a detail in perspective of the tubular members. Fig. 6 is adetail of the telescoping rod. Fig. 7 is a detail showing the method ofattaching the Wire filament. Fig. 8 is a fragmentary section of the endof one of the levers showing the spring clips which secure the operatingparts on the levers. Fig. 9 is a longitudinal sectional view of theoperating members when used as a snare only.

By operating parts is meant the telescoping members and the meanscarried thereby for removing and gripping the growth.

In the specific construction shown in the drawings, the levers 1 and 2are pivoted together at 3 intermediate of their ends so as to formhandles 4 and 5, which have ears 6 integrally formed thereon to preventslipping of the instrument in the hands. In the opposite ends of thelevers land 2 are formed cylindrical sockets 7 extending inward from oneface of the levers, and in which are retained the trunnion parts 8.

Each of the parts 8 has a reduced trunnion 9 formed on one side, whichregisters with the aperture or hearing 10. The parts 8 are each held inplace on the levers by a spring slide 11, which is secured thereto byscrews 12, and the sliding movement thereof is limited by the slot 13. Alug 14: on the slide 11 coacts with a slot 15 in the levers, and keepsthe slide from being displaced,

the slide being moved by pressing on the finger 16.

The tubular member 17 is integrally formed on the part 8, carried by thelever 1, and the telescoping member or rod 18 eX- tends through the slot19 in the other part 8 carried by the lever 2. Transverse slots 21 allowfor an angular movement of the members 17 and 18. The rod 18 isthreaded,

' and carries the nut 22 outwardly of the le- *ver 2, by means of whichthe members 17 and 18 may be moved relatively of each other,independently of the levers 1 and 2,

for the purpose of adjustment. The rod 18 has an extension 23 which may,if desired, be integrally formed therewith, as shown in Fig. 9, or itmay be a separate piece, having an elongated slot 24:, with which a lug25 on the rod 18 may register and allowfor a small amount of relativemovement where the instrument is equipped with gripping jaws. Theextension 23 has two transverse eyes 26 formed in the end thereof,through which may be threaded the ends of a wire filament 27.

In order to grip the growth that is to be cut away, and prevent itsfalling, and to eliminate the necessity of a separate instrument forsuch purpose, there is arranged at the end of' the telescoping members17 and 18, a pair of jaws 28 and 29, which are integrally formed on thearms 30 and 31. The arms 30 and 31 are connected together slightlyforward of their ends by means of a screw 32, by which they are alsosecured to the member 17, and the rearwardly extending shoulders 33normally abut against each other and are secured in engagement with eachother by means of a clip 34, which is held in place by the screw 32, sothat the contraction and expansion of the jaws depends upon theresiliency of the arms 30 and 31. The arms are bent so as to cross eachother, intermediate of their ends, and the jaws thereon are normallyurged apart by the resilient structure of the arms. The arms 30 and 31are bent outwardly around the pin 35, carried by the rod 18, and crossedforwardly thereof, so that as the pin 35, which travels in the slot 36,formed in the member 18, is drawn rearwardly along and between the arms30 and 31, the adjacent parts of the arms are forced apart, causing aoperating parts, two of which are shown in the drawings. The instrumentshown attached to the levers in Fig. l is particularly adapted for usein removing adenoids, and the instrument shown in Fig. 9 shows the oneusually used for the removal of the tonsils.

It often happens that when it is necessary to remove such growths asadenoids, it is also necessary to remove the tonsils at the same time,in which case, the

surgeon will have both instruments in readiness. If the adeno-ids are tobe removed first, the instrument for that purpose will be connected tothe handles as shown in Fig. 1. This is done by pushing the springslides 11 rearwardly along the levers, in-

. connection.

serting the cylindrical parts .8 into the sockets 7, and pushing theslides forwardly, so as to bear on the flat surface of the parts 8, andthereby secure the parts inoperative The nut 22 is turned back so as toextend the end of the extension 23 beyond the end of the tubular member17 to permit the easy threading of the wire filament 27 through theapertures 26. The nut 22 may then be turned forwardly so as to withdrawthe ends of the filament into the tube 17 to cause it to be adjusted tothe desired size. After this adjustment is made, opposite sides of thefilament may be now slipped under the lips 37 and the instrument isready for use. The instrument is then placed overthe growth, and thehandles 4 and 5 are pressed together. This gives the members 17 and 18 arelatively longitudi- I nal movement, and as the pin 35 travels backwardalong the arms 80 and 81, the jaws 28 and 29 are forced into grippingengagement with the growth, and the wire filament 27 is contracted anddrawn through the growth. The resilient structure of the arms 30 and 31allows the jaws to yield after engaging the growth, and thereby permitthe continued contraction .of the filament. The operating parts can thenbe quickly separated from the levers, and other operating partssubstituted for further operation on the adenoids or the removal of thetonsils.

An important feature of this device is the pivoting of both of theoperating members to their respective levers, as it permits the handlesto be operated without tending to cause displacement of the snare, whichfrequently happens in instruments where one of the handles is rigidlyconnected to one of the parts of the operating stem, in which case, thewhole stem tends to swing in an are about the pivotal connection betweenthe handles.

Although but one specific embodiment of this invention is herein shownand described, it will be understood that numerous details of theconstruction shown may be altered or omitted without departing from thespirit of this invention as defined by the following claims.

We claim 1. A surgical instrument, comprising a pair of levers pivotallyconnected together, a pair of members slidable lengthwise one along theother and respectively connected to said levers, operating means carriedat the end of said members and actuated through the relativelongitudinal movement of said members, a pair of jaws carried by one ofsaid members and disposed adjacent to said operating means and in aplane transverse to said members, and means carried by the other saidmember for causing the relative movement of said jaws simultaneouslywith the actuation of said operating means.

2. A surgical instrument, comprisin a pair of levers pivotally connectedtogether, a pair of members slidable lengthwise one along the other andrespectively connected to said levers, a snare carried at the end ofsaid members and actuated through the relative longitudinal movement ofsaid members, a pair of jaws carried by one of said members and disposedadjacent to said snare and in a plane transverse to said members, meanscarried by the other said member for causing the relative movement ofsaid jaws simultaneously with the actuation of said snare, and means forsupporting said snare in a plane parallel to the operating plane of saidjaws.

3. A surgical instrument, comprising a pair of levers pivotallyconnected together, a pair of members respectively connected to saidlevers and adapted to be moved longitudinally of each other, a pair ofarms having spring shanks rigidly connected at their inner ends to oneof said members and being crossed adjacent to their outer ends, coactingjaws on the outer ends of said arms, a projection carried by said othermember and adapted to coact with the opposed edges of said arms inwardof the point of said crossing to cause the closing of said jaws throughthe relative movement of said members.

4. A surgical instrument, comprising a pair of levers pivotallyconnected together, a pair of members relatively slidable lengthwise onealong the other, a trunnion on each of said members, a bearing on eachof said levers for the respective trunnions, means for detachablyholding said trunnions in said bearings, and a snare loop carried by oneof said members and adapted to be contracted through the relativemovement of the other said member.

5. A surgical instrument, comprising a pair of levers pivotallyconnected together intermediate of their ends, a socket in the end ofeach of said members, a trunnion mounted to rotate in each of saidsockets, a pair of members respectively connected to said trunnions, andmeans carried by one of said members and adapted to be contracted orexpanded through the relative movement of said other member.

6. A surgical instrument, comprising a pair of levers pivoted togetherintermediate of their ends, a substantially cylindrical socket formed inthe end of each of said levers, a pair of members relatively slidablelengthwise, one along the other, having trunnion bosses carrying saidmembers and adapted to be rotatably supported in the sockets of therespective levers, and means carried by one of said members and adaptedto be contracted through the relative movement of the other said member.

7. A surgical instrument, comprising a pair of levers pivotallyconnected together, a pair of members relatively slidable lengthwise onealong the other, a trunnion on each of said members, a bearing on eachof said levers for the respective trunnions, a slide on each of saidlevers adapted to be shifted into position for holding said trunnions insaid bearings, and a snare loop carried by one of said members andadapted to be contracted through the relative movement of the other saidmember.

8. A surgical instrument, comprising a pair of levers pivotallyconnected together intermediate of their ends, a tube pivotallyconnected to one of said levers, a rod pivotally connected to said otherlever and telescoping with said tube, said rod being slidable relativeto its pivotal connection and having a part thereof threaded, and a nutengaging said threads and adapted to cause relative movement of said rodand tube when said levers are relatively stationary, and a snare adaptedto be contracted through the relative movement of said tube and rod,

9. A surgical instrument, comprising an operating stem, a filamentlooped to form a snare at one end of said stem, a pair of jaws mountedon said stem and disposed in a plane transverse to said stem and movabletoward and away from each other, means operative from the opposite endof said stem for contracting said snare and closing said jaws, and meanson said jaws adapted to engage opposite parts of said snare forsupporting and guiding the same, in a plane substantially parallel withthat of said jaws.

10. A surgical instrument, comprising an operating stem, a filamentlooped to form a snare at one end of said stem, a pair of jaws mountedon said stem and disposed in a plane transverse to said stem and movabletoward and away from each other, means operative from the opposite endof said stem for contracting said snare and closing said jaws, and meanson said jaws adapted to engage opposite parts of said snare forsupporting and guiding the same in a plane substantially parallel withthat of said jaws, said snare engaging means being shaped to permit saidsnare to be withdrawn and continue its contraction after the closing ofsaid aws.

Signed at Chicago this 27th day of September 1910. I

FREDERICK R. MUELLER. LOUIS REHTHALER.

Witnesses:

EUGENE A. RUMMLER, EDWIN PHELPS.

Copies of this patent may be obtained for five cents each, by addressingthe Commissioner of Patents, Washington, D. G.

